Request for Literature Boater Education



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Date conversion09.01.2018
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Request for Literature
Boater Education  

Order Date:

     




*** Instructor ID # and course information required for all orders. ***  

Ship To:

   Volunteer Instructor

   Professional Educator

(Note: Freight delivery cannot be made to a Post Office Box Address.)  

   Game Warden

   TPWD Employee

Name:

     

Instructor ID#:

     

Attention:

     

Course Start Date:

     

Address 1:

     

Course Start Time:

     

   a.m.    p.m.

Address 2:

     

Location/Address:

     

City:

     

City:

     

State, Zip:

  ,      

Course Contact Phone:

(       )      




E-mail:

     

**** Please ship education material for a class of       students OR needed material listed below. ****

Item Number

Description

Order Quantity

Issued

Comment

OL 00436  

Boat Texas – A Course on Responsible Boating  

     




One per student  

OL 00133  

A Digest of the Water Safety Act – Brochure  

     




One per student  

OL 00315  

Enroll in a Boater Education Course – Poster  

     




If needed  

OL 00352  

A Teaching Guide to Responsible Boating  

     




*One per instructor  

OL 00131  

Boater Education Program – Brochure  

     




One per student  

OL 00134  

Boat Texas DVD for TV (Order only if you don’t have one)  

     




*One per instructor  

OL 00134  

Boat Texas DVD for Computer (Order only if you don’t have one)  

     




*One per instructor  

OL 00134  

Boat Texas Power Point CD (Order only if you don’t have one)  

     




*One per instructor  

OL 00233  

Student Registration Form  

     




One per student  

OL 00234  

Supply Order Form  

     




If needed  

OL 00717  

Instructor’s Student Roster  

     




*One per instructor  

OL 00117  

Instructor Course Final Report  

     




*One per instructor  

OL 00252  

Business Reply Envelope  

     




One per class  

     

     

     







     

     

     







     

     

     










Send Supply Order Form To:  

Texas Parks and Wildlife Department


Education Fulfillment
4200 Smith School Road
Austin, Texas 78744

Fax: (512) 389-4372

E-mail: supply.request@tpwd.texas.gov  



*Instructor Use Only  

For TPWD
Use Only

Carrier:


Filled By:


Date:





PWD 0183A – K0700 (10/13)


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